Doctors at the U.S. National Cancer Institute concluded that Perkins wouldn't survive with conventional therapy and as a result picked her for a radical new therapy which harnessed the power of her immune system to fight the tumors.
A 21-gene test called Oncotype Dx that has been around since 2004 has helped guide some decisions, post-surgery.
The results reflect a trend of moving away from chemo to treat cancer and, when it is used, it's for shorter periods at smaller doses.
Treatment for sufferers may involve radiotherapy or surgery.
Thousands of breast cancer patients may be safely spared gruelling chemotherapy following a landmark study. "It's exactly the sort of study that we need to make decisions about these genomic tests". It involved more than 10,000 women with breast cancer that had not spread to nearby lymph nodes and whose tumours respond to hormone therapy and test negative for the HER2 gene.
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The study enrolled 10,273 women, of whom 9719 with follow-up data were included in the main analysis set; 6711 women (69%) had an intermediate recurrence score of 11-25, while 1619 (17%) had a low recurrence sore of 10 or less and 1389 (14%) had a recurrence score of 26 or higher. Endocrine therapy, such as tamoxifen, is more important with this disease than chemotherapy, said Otis Brawley, chief medical and scientific officer for the American Cancer Society. After nine years, 94% of both groups were still alive and about 84% were alive without signs of cancer, meaning that the chemo made no difference.
Findings of the past have indicated that women who met these criteria and scored below ten on the index test could safely skip chemotherapy without raising their rate of recurrence, however, those above 25 would nearly always be advised to use chemotherapy as a necessary treatment to lower risk of recurrence.
"That's obviously huge for the individual patient".
Research has shown that Oncotype Dx and other tests, including Breast Cancer Index and EndoPredict, vary in accuracy, particularly when predicting the long-term risk of someone's cancer coming back. "I spoke to four people about her case, including one of the doctors associated with the Tailorx trial", said Dr Ramesh Sarin, senior consultant surgical oncology at the Indraprastha Apollo Hospitals. Such individualized therapies promise to be more effective and cause fewer side effects than more traditional ones developed for the average patient. They could potentially encourage patients to incorrectly avoid or stop treatment - with potentially tragic consequences. We think this area needs more voices, reasoned analysis and ideas than just those provided by News Corp, lifestyle mags, Facebook groups and corporate newsletters.
Tuttle said just having radiation was tough to go through and can't imagine going through chemo on top of it. Some women 50 or younger, however, did see benefits from chemo.
"The impact is tremendous", study leader Joseph Sparano of Montefiore Medical Center in NY told USA Today.
"I was a little relieved".
She had undergone a mastectomy in 2003 after the cancer was first diagnosed.